User involvement in healthcare technology development and assessment: Structured literature review

Purpose – Medical device users are one of the principal stakeholders of medical device technologies. User involvement in medical device technology development and assessment is central to meet their needs. Design/methodology/approach – A structured review of literature, published from 1980 to 2005 in peer-reviewed journals, was carried out from social science perspective to investigate the practice of user involvement in the development and assessment of medical device technologies. This was followed by qualitative thematic analysis. Findings – It is found that users of medical devices include clinicians, patients, carers and others. Different kinds of medical devices are developed and assessed by user involvement. The user involvement occurs at different stages of the medical device technology lifecycle and the degree of user involvement is in the order of design stage > testing and trials stage > deployment stage > concept stage. Methods most commonly used for capturing users’ perspectives are usability tests, interviews and questionnaire surveys. Research limitations/implications – We did not review the relevant literature published in engineering, medical and nursing fields, which might have been useful. Practical implications – Consideration of the users’ characteristics and the context of medical device use is critical for developing and assessing medical device technologies from users’ perspectives. Originality/value – This study shows that users of medical device technologies are not homogeneous but heterogeneous, in several aspects, and their needs, skills and working environments vary. This is important consideration for incorporating users’ perspectives in medical device technologies. Paper type: Literature review

What They Gain Depends on What They Do: An Exploratory Empirical Research on Effective Use of Mobile Healthcare Applications

Mobile healthcare application receives widespread attention, although it has advanced technology and user-friendly design, when users don’t use it effectively, it seems worthless. Research mainly focus on technology improvement. But how to improve user behavior to match the technology is another essential factor for facilitating effective use from managerial perspective. We introduced the task technology fit theory to explain the mechanism when user using the applications. We added perceived e-health literacy as moderator variable, considering the user characteristic and medical environment. The data was collected from student samples of two schools (medical and non-medical related universities), totally 178 valid samples. Our research indicates adaptation and learning behavior have significantly positive impact on the efficiency use and effectiveness use. The perceived e-health literacy only has significant moderator effect on learning behavior. Our study provides practical implications for both software providers and users to achieve effective use of mobile healthcare applications

Open electronics for medical devices: State-of-art and unique advantages

A wide range of medical devices have significant electronic components. Compared to open-source medical software, open (and open-source) electronic hardware has been less published in peer-reviewed literature. In this review, we explore the developments, significance, and advantages of using open platform electronic hardware for medical devices. Open hardware electronics platforms offer not just shorter development times, reduced costs, and customization; they also offer a key potential advantage which current commercial medical devices lack—seamless data sharing for machine learning and artificial intelligence. We explore how various electronic platforms such as microcontrollers, single board computers, field programmable gate arrays, development boards, and integrated circuits have been used by researchers to design medical devices. Researchers interested in designing low cost, customizable, and innovative medical devices can find references to various easily available electronic components as well as design methodologies to integrate those components for a successful design

Provisioning Quality of Service of Wireless Telemedicine for E-Health Services: A Review

In general, on-line medical consultation reduces time required for medical consultation and induces improvement in the quality and efficiency of healthcare services. The scope of study includes several key features of present day e-health applications such as X-ray, ECG, video, diagnosis images and other common applications. Moreover, the provision of Quality of Service (QoS) in terms of specific medical care services in e-health, the priority set for e-health services and the support of QoS in wireless networks and techniques or methods aimed at IEEE 802.11 to secure the provision of QoS has been assessed as well. In e-health, medical services in remote places which include rustic healthcare centres, ships, ambulances and home healthcare services can be supported through the applications of e-health services such as medical databases, electronic health data and the transferring of text, video, sound and images. Given this, a proposal has been made for a multiple service wireless networking with multiple sets of priorities. In relation to the terms of an acceptable QoS level by the customers of e-health services, prioritization is an important criterion in a multi-traffic network. The requirement for QoS in medical networking of wireless broadband has paved the way for bandwidth prerequisites and the live transmission or real-time medical applications. The proposed wireless network is capable of handling medical applications for both normal and life-threatening conditions as characterized by the level of emergencies. In addition, the allocation of bandwidth and the system that controls admittance designed based on IEEE 802.16 especially for e-health services or wireless telemedicine will be discussed in this study. It has been concluded that under busy traffic conditions, the proposed architecture can used as a feasible and reliable infrastructure network for telemedicine

Securing CAN-Based Cyber-Physical Systems

With the exponential growth of cyber-physical systems (CPSs), new security challenges have emerged. Various vulnerabilities, threats, attacks, and controls have been introduced for the new generation of CPS. However, there lacks a systematic review of the CPS security literature. In particular, the heterogeneity of CPS components and the diversity of CPS systems have made it difficult to study the problem with one generalized model. As the first component of this dissertation, existing research on CPS security is studied and systematized under a unified framework. Smart cars, as a CPS application, were further explored under the proposed framework and new attacks are identified and addressed. The Control Area Network (CAN bus) is a prevalent serial communication protocol adopted in industrial CPS, especially in small and large vehicles, ships, planes, and even in drones, radar systems, and submarines. Unfortunately, the CAN bus was designed without any security considerations. We then propose and demonstrate a stealthy targeted Denial of Service (DoS) attack against CAN. Experimentation shows that the attack is effective and superior to attacks of the same category due to its stealthiness and ability to avoid detection from current countermeasures. Two controls are proposed to defend against various spoofing and DoS attacks on CAN. The first one aims to minimize the attack using a mechanism called ID-Hopping so that CAN arbitration IDs are randomized so an attacker would not be able to target them. ID-Hopping raises the bar for attackers by randomizing the expected patterns in a CAN network. Such randomization hinders an attacker’s ability to launch targeted DoS attacks. Based on the evaluation on the testbed, the randomization mechanism, ID-Hopping, holds a promising solution for targeted DoS, and reverse engineering CAN IDs, and which CAN networks are most vulnerable. The second countermeasure is a novel CAN firewall that aims to prevent an attacker from launching a plethora of nontraditional attacks on CAN that existing solutions do not adequately address. The firewall is placed between a potential attacker’s node and the rest of the CAN bus. Traffic is controlled bi-directionally between the main bus and the attacker’s side so that only benign traffic can pass to the main bus. This ensures that an attacker cannot arbitrarily inject malicious traffic into the main bus. Demonstration and evaluation of the attack and firewall were conducted by a bit-level analysis, i.e., “Bit banging”, of CAN’s traffic. Results show that the firewall successfully prevents the stealthy targeted DoS attack, as well as, other recent attacks. To evaluate the proposed attack and firewall, a testbed was built that consisted of BeagleBone Black and STM32 Nucleo- 144 microcontrollers to simulate real CAN traffic. Finally, a design of an Intrusion Detection System (IDS) was proposed to complement the firewall. It utilized the proposed firewall to add situational awareness capabilities to the bus’s security posture and detect and react to attacks that might bypass the firewall based on certain rules

3D Printed Microfluidic Devices

3D printing has revolutionized the microfabrication prototyping workflow over the past few years. With the recent improvements in 3D printing technologies, highly complex microfluidic devices can be fabricated via single-step, rapid, and cost-effective protocols as a promising alternative to the time consuming, costly and sophisticated traditional cleanroom fabrication. Microfluidic devices have enabled a wide range of biochemical and clinical applications, such as cancer screening, micro-physiological system engineering, high-throughput drug testing, and point-of-care diagnostics. Using 3D printing fabrication technologies, alteration of the design features is significantly easier than traditional fabrication, enabling agile iterative design and facilitating rapid prototyping. This can make microfluidic technology more accessible to researchers in various fields and accelerates innovation in the field of microfluidics. Accordingly, this Special Issue seeks to showcase research papers, short communications, and review articles that focus on novel methodological developments in 3D printing and its use for various biochemical and biomedical applications